Op-Ed

Trump might be mentally unstable, but it’s unethical for psychiatrists to imply it

Psychiatrists who pronounce President Trump mentally unstable without a diagnosis are violating the industry’s Goldwater Rule.
Psychiatrists who pronounce President Trump mentally unstable without a diagnosis are violating the industry’s Goldwater Rule. NurPhoto via Getty Images

Most of mental health experts’ attacks on President Trump’s psychological qualifications to be president have violated the “Goldwater Rule,” the informal name given to section 7.3 of the American Psychiatric Association’s “Principles of Medical Ethics.”

It says that it is “unethical for a psychiatrist to offer a professional opinion about an individual based on publicly available information without conducting an examination.”

The rule came about after the publication of an infamous 1964 article in Fact Magazine, in which more than 1,100 psychiatrists wrote in to publicly diagnose and assess presidential nominee Barry Goldwater, a solid conservative Republican. One Los Angeles psychiatrist said he found Goldwater unfit for the office because of “his impulsive, impetuous behavior.”

“Such behavior,” the psychiatrist wrote, “in this age could result in world destruction. This behavior reflects an emotionally immature, unstable personality. … Basically I feel he has a narcissistic character disorder with not too latent paranoid elements.”

The embarrassment to psychiatry from the irresponsible responses of almost 10 percent of America’s psychiatrists was immediate and has never abated. Hence, the Goldwater Rule was adopted by the APA to reduce the pretensions of psychiatrists and to protect unexamined public figures.

But it seems to have fallen by the wayside under President Trump.

His election has manifestly frightened and concerned perhaps a majority of American citizens — myself included. To accept that such a volatile president presides over the world’s largest and most effective nuclear weapons stockpile is sobering indeed. Regardless, the American people through their valid electoral system elected him, and those who are trying to remove him through psychiatric mystification are violating democratic norms through a pseudo-medical storm of disparagement.

Those engaged in this attempt include Maryland Congressman Jamie Raskin and more than four dozen co-signers of the Oversight Commission on Presidential Capacity Act. That act would enfranchise a commission to assess whether the president is psychiatrically qualified to be in the office, consistent with, as Raskin puts it on his web page, “Section 4 of the 25th Amendment (which) empowers Congress to establish a permanent ‘body’ that can declare that the President is ‘unable to discharge the powers and duties of his office.’ 

This effort to use psychiatry and psychology to enable legislators to remove a president has been given an additional bump through a well-publicized book edited by Dr. Bandy X. Lee, entitled “The Dangerous Case of Donald Trump.”

The book’s authors are a varied bunch of psychiatrists — many, but not all, well-known and prestigious — other mental health professionals and a few journalists, lawyers and others who present a number of similar attacks on Trump.

Many of them reference the Goldwater Rule to either oppose it or to explain why their judgments are somewhat attenuated. A few of the articles just make general points about the dangers of a narcissistic or mentally ill president or person, whereas others volunteer actual diagnoses of Trump.

The book’s most frequent diagnosis is that Trump has “narcissistic personality disorder,” via his public attitude and rhetoric. Some of the writers argue that he is delusional and/or paranoid, but the majority agrees that he is “dangerous,” especially in a nuclear age. (Sound familiar?)

There is no mention of the fact that psychiatry has never established its ability to predict dangerousness beyond what smart laypeople can predict. In fact, the APA has itself stated as recently as last year that, “While psychiatrists can often identify circumstances associated with an increased likelihood of violent behavior, they cannot predict dangerousness with definitive accuracy.”

The psychiatric movement to remove President Trump is a progressive movement, the dominant philosophy of psychiatry. One can see left-wing criticism of the president’s positions throughout the Lee book and the admission by a few authors that psychiatry is a “liberal” profession.

No one can doubt the sincerity of the Trump-hating psychiatrists, but their flouting of the Goldwater Rule is nothing but unprofessional venting.

Richard E. Vatz is a professor at Towson University and is author of “The Only Authentic Book of Persuasion: the Agenda-Spin Model.”

(c) 2018 The Baltimore Sun

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